Knowledge, Perception, and Uptake of Influenza, Pneumococcal, and COVID-19 Vaccination among Patients with Heart Failure: A Cross-Sectional Study from a Tertiary Care Cardiac Center

Abstract

Objectives: This study aimed to evaluate the knowledge, perceptions, and uptake of influenza, pneumococcal, and Coronavirus Disease 2019 (COVID-19) vaccines among patients with heart failure (HF) presenting to a tertiary care cardiac center and to identify factors associated with vaccine compliance and hesitancy. Methodology: This analytical cross-sectional included patients aged above 30 years with clinically and echocardiographically confirmed HF were enrolled using consecutive sampling after obtaining informed consent. Data regarding demographics, vaccination status, vaccine-related knowledge, perceptions, and barriers to vaccination were collected using a structured questionnaire. Vaccination status was determined primarily through self-report and verified using vaccination cards where available. Results: A total of 258 participants were included in the final analysis, with a mean age of 56.3 ± 13.2 years, and 75.2% (n=194) were male. Uptake of influenza, COVID-19, and pneumococcal vaccines was observed in 23.6% (n=61), 77.1% (n=199), and 14.7% (n=38) of participants, respectively. Influenza and pneumococcal vaccination status showed significant associations with socioeconomic status and place of residence, while educational status and duration of HF were additionally associated with influenza vaccination uptake. Knowledge regarding vaccine availability, physician recommendation, and positive perceptions regarding vaccine safety demonstrated strong associations with uptake of all three vaccines (p<0.001). Major barriers to vaccination included lack of physician recommendation, unawareness regarding vaccine availability, financial constraints, and misconceptions related to vaccine safety and effectiveness. Conclusion: Vaccination uptake among patients with HF, particularly for influenza and pneumococcal vaccines, remains suboptimal despite established guideline recommendations. Limited awareness, inadequate physician counseling, socioeconomic disparities, and vaccine-related misconceptions were identified as major barriers to vaccine compliance. Targeted patient education, physician-driven counseling, and improved accessibility and affordability of vaccines may help enhance vaccination coverage in this high-risk population.